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Home My WebLink AboutSKIDMORE, CHERYL KIDS CAN DO GYMNASTICS dba FUN WITH HORSES 2cCity of Santa Ana Clerk of the Council AGREEMENT TERMINATION C 2~~ 7~R !~'? ~ 3 ~"~ 9~ ~ 2 Please complete this form when the attached agreement is no longer in a ect. " Return form to the Clerk of the Council Office (M-30). Call 647-2520 if you have any questions. ~ ~ ; ~~ "~• F'' t The agreement with Cheryl Skidmore Kids Can Do Gymnastics dba Fun With Horses No. N-2004-058; N-2004-058-01; N-2004-058-02; N-2004-058-03; N-2004-058-04 and final payment has been made. was completed on 12-31-08 Department: PRCSA Phone/Ext.: 4203 Signature: e ~~~~1~~~ Date: 7-21-09 Revised 05-04-08 N-2004-058-03 "..,..... i\,~ 3{-01 -_.~'-'-"'-'" : '~~ )./(- 01 .'. -_.-...-...... . PQt> 0.) D. - >J l<:-~ THIRD AMENDMENT TO CONSULTANT AGREEMENT THIS THIRD AMENDMENT TO CONSULTANT AGREEMENT is entered into this 20th day of November, 2006, by and between Kids Can Do Gymnastics dba Fun With Horses (hereinafter "Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). RECITALS: A. The parties entered into Agreement N-2004-058, dated May 1,2004, (hereinafter "said Agreement") by which Consultant has instructed horsemanship camps through the City's leisure class program. B. In accordance with the terms and conditions of said Agreement, the parties wish to renew said Agreement for an additional one-year period. WHEREFORE, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this Third Amendment to Consultant Agreement, the parties agree as follows: I. Section 3, TERM shall be amended to extend the term through December 31, 2007. 2. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Amendment to Consultant Agreement on the date and year first written above. CITY OF SANTA ANA APPROVED AS TO FORM: ~~~~J ! Executive Director i Parks, Recreation and Community Services Agency J SEPH W. FLETC R City Attorney Clu r~ . . ~ :7_(2-?>(C7 \~:.v~ L^-"-- lJ-v (~~~) ~- 0-~ ~'v~~ j ~J~ ACORD. CERTIFICATE OF LIABILITY INSURANCE CSR RD I DATE(MMIDDIYYYY) 10/23/06 ----=:- - SKIDM-1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cheval Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIACATE Lie. OC94257 HOLDER. THIS CERTIACATE DOES NOT AMEND, EXTEND OR P. O. Box 2933 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Fullerton CA 92837 Phone: 714-447-9191 Fax: 714-525-9191 INSURERS AFFORDING COVERAGE NAIe. INSURED INSURER 1.:. American Bankers INSURER B: Che'11 Skidmore INSURER c: Fun i th Horses 187 E. Wilson St. INSURER 0: Costa Mesa CA 92627 INSURER E: COVERAGES THE POLICIES OF INSURANCE LiSTED BElOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR me POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IssueD OR MAY PERTAIN, THE INSURANCE AFFORCED BY THE POLICIES DESCRISED HEREIN IS SUB..ECT TO AlL THE TERMS, EXCLUSIONS AND CONomONS OF SUCH :is. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~~ ..!:!!. SR TYPE OF INSURANCE POLICY NUMBER DATE UMITS ~NERAL UA8Il.JTY EACH OCCURRENCE .1,000,000 A X X COMMERCIAl GENERAL LIABILITY SLll03177 08/31/06 08/31/07 PREMlSES';'~~1 .50.000 I CLAIMS MADE ~ OCCUR MtOO EXP (Anyone persoo) $ 5,000 - PERSONAL & ADV INJURY .2,000,000 - GENERAL AGGREGATE .2 000,000 ~'LA~r~!r WAtT APnSPER: PRODUCTS-COM~OPAGG .2,000,000 X POLICY ~~gT LOC ~TOMOBLE LIABILITY COMBINED SINGLE LIMIT . ANY AUTO NONE (Ea acddent) - -- ALL OWNED AUTOS BODlL Y INJURY (Per person) . - SCHEDULED AUTOS - HtRED AUTOS BODILY INJURY . NQN..OWNED AUTOS (Per accident) - -- - PROPERTY DAMAGE . (Perac:ddent) =r~ AUTO ONLY - EA ACCIDENT . ANY AUTO NONE OTHER THAN EA ACC . AUTO ONLY: AGG . EXCESSIUMBREUA UABlLITY EACH OCCURRENCE . ~TOCCUR D CLAIMS MADE NONE AGGREGATE . . ~ DEDUCTIBLE . RETENTION . . WORKERS COMPENSATION AND . i...,; ITDRYLlMITS I IOJ~- EMPLOYERS' LIABILITY -' ANY PROPR1ETORIPARTNERlEXECUTIVE NONE /?)~~j E.L EACH ACCIDENT . OFF1CERlMEMBER EXCLUDED? {J /1 <:".~ E.l. DISEASE - EA EMPLOYEE $ If yes, describe uncIer SPECIAL PROVISIONS below ...~._,~- E.L DISEASE - POLICY LIMIT . OTHER '7 , NONE i ,"- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSfONS ADDED BY ENDORSEMENT I SPEcw.. PROVISIONS Certificate holder is additional insured as sponsor of recreational program but onl.y insofar as insured operations in connection with said insured CERTIFICATE HOLDER CANCELLATION CITYSA SHOULD ANY OF THE ABOVE DESCRIBED POUCJES BE CANCELJ.ED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WlLJ.,ENDEAVOR TO MAIL !..!!.- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NffD TO THE LEFT, BUT FAILURE TO DO so SHAll IMPOSE NO OBLIGATION OR UABIUTY Of~Y KtND UPON THE INSURER, ITS AGENTS OR REPRESENTATNES- AUTHORIZED REPRESEN~ ices City of Santa Ana Parks & Recreation Peggy Calvert 888 W Santa Ana Blvd. #200 Santa Ana CA 92701 Cheval Insurance S ACORD 25 (2001/08) @ACORDCORPORATION1988 - JPec. 7. 2006 10: 11AM CHEVAL INSURANCE . No. 9829 P 3 10lB ~ d'langes the CO/11I1IefdaI UabllitY CovetBgElII provlded by \hill policy _ pt.EASE READ nus CAREJ'Uu. y - ADDmONAL INSURED DESIGNATED PARTY Gl-841 Ed. 1.0 MIS $ch8dula h.r...n,""," . beIllW b..ll"'''' on . ~ or 0e<;I8CaG0nS. \ __ CIJYOl'SANTAANAPAR<S&REC OlIsilInatsd Adlvity: :''95ign91ed lnleresls: SKIDMORE, CHERYL Tc3 Co!'/1I1ll!l'Ci Liabil1tY Coverage is emended as follows: J actiVfties deBignat8d ill the Schedule rating to: e. your- operations; b. premises owned by or rented to you. or c. olI1ef dJ '.)laled ~.t\roes\S shown In the SchedUle. ( h~EFlNmoNS The d\6.litiOn of in&l.lred Ie emended to include the ::;,.C"~ '~",\.1!'9d ebo il1dUdes the party design8ted in the "c~e-.!'Jle but oiiIywill\ nispIiCt to liabilityll!lsing out.of GL-841 Ed 1.0 eopyngIItMCMXCI. AmBriton ~ c1_SeN1-' MIS i ~ ~t ~Iii ~ ''-7// /; ,/'.. .( j'''--j'''''-::- /.. '......._-- /,./ ../"'./ I ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP ID RD I DATE (UMlDDIYYYY) SKJ:DM 1 03/03/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION Cheval Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lie. OC94257 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 2933 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Fullerton CA 92837 Phone: 714-447-9191 Fax: 714-525-9191 INSURERS AFFORDING COVERAGE NAlC.. INSURED Cheryl Skidmore A1- rRCO<I-o~f/- INSURER A: American Bankers INSURER B: Kids Can Do ~astics 03 INSURER c: dba Fun With orses 187 E. Wilson St. ----.- -.------ Costa Mesa CA 92627 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmoNS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE U/NDDIYY1 D'k%TIMMlDONV)" LIMITS GENERAL LIABILITY EACH OCCURRENCE 11.000.000 L- A X ~ 3MMERCIAL GENERAL LIABILITY SL1103177 08/31/07 08/31/08 I PREMiSES lea occunnc:e) $ 50 .000 f--- ClAIMS MADE ~ OCCUR MED EXP (Any one person) I 5,000 PERSONAL & AI:N INJURY $1.000.000 GENERAL AGGREGATE $2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS.CDM~PAGG $ 2,000.000 Xl POLICY n ~8T n LOC AUTOMOBILE LIABILITY COMBINED SINGLE UI'IIT - . ANY AUTO NONE (b accident) - ALL OWNED AUTOS BDOIL Y INJURY - . SCHEDULED AUTOS (Per""......,) - - HIRED AUTOS BODILY INJURY . NON-OWNED AUTOS (Per accident) -- - PROPERTY DAMAGE . (Per Kcldlnt' GARAGE LIABILITY AUTO ONlY. EA ACCIDENT . R ANY AUTO NONE OTHER THAN EA ACC $ AUTO ONLY: AGG . EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ tJ OCCUR D CLAlIiIS MADE . NONE AGGREGATE $ $ R DEDUCTIBLE I .- RETENTION $ $ WORKERS COMPENSATION AND I TORY" uMiT's I IO~. EMPLOYERS LIABILITY NONE M1Y PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? EL. DISEASE . I!A EMPLOYEE $ It yes., describe under SPECIAL PROVISIONS below E.L DISEASE. POUCY UMIT . OTHER NONE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is additional insured as sponsor of recreational program but only insofar as insured operations in connection with said insured. CERTIFICATE HOLDER CANCELLATION CITY SA SMOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Community Development Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL M 25 Attn: Deborah ;po Box 1988 IMPOSE NO OBliGATION DR .1} ILfTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR Santa Ana CA 92702 REPRESENTATIVES. AUTHORIZED REPRESENT} I~ ~ces Cheval Insur ACORD 25 (2001108) 4 ;/2... @ACORD CORPORATION 1988 // /~/--Ci.- \ ./' y AAIS This endorsement changes the Commercial liability Coverages provided by this policy -- PLEASE READ THIS CAREFULLY - GL.B41 Ed. 1.0 ADDITIONAL INSURED DESIGNATED PARTY Iemental Declarations. Designated party: CITY OF SANTA ANA PARKS & REC Designated Activity: SPONSOR REC PROGRAM Designated Interests: KIDS CAN DO GYMNASTICS INe The Commercial Uability Coverage is amended as follows: I DEFINITIONS _.~ activities designated in the Schedule rating to: The definition of Insured is amended to Include the following: a. your operations; b. premises owned by or rented to you, or c. other designated interests shown in the Schedule. Insured also includes the party designated In the Schedule but only with respect to liability arising oul of GL-B41 Ed 1.0 Copyright MCMXCI, American Association of Insurance Servlces AAIS